Priority One Registration Form

PLEASE PROVIDE PARENTS' / GUARDIANS' EMERGENCY DETAILS

Emergency Contact (Mother)

Emergency Contact (Father)

Emergency Contact (Other)

PLEASE ACCEPT BELOW IF PHOTOS MAY BE TAKEN


YesNo

THIS STANDARD INDEMNITY MUST BE ACCEPTED BY PARENT OR GUARDIAN

As parent / guardian of the above Priority One Plus member, I am willing for him/her to be part of the Priority One Group at Sherwood Uniting Church, to be held Friday nights of school terms at the Sherwood Uniting Church hall, cnr Sherwood Rd and Thallon St Sherwood 4075, or at a venue that the Priority One group may from time to time travel to while on an outing. I understand the nature of the activities of Priority One will include, but will not be limited to physical games, outings and travel to and from the same, concerts, craft, bible studies, craft, eating and that risks may arise during these activities. I hereby authorise the leader in charge of Priority One or of the particular activity in which my child is involved to consent, where impracticable to communicate with me, to my child receiving such medical or surgical treatment as the leader may deem necessary at any time during Priority One programmes. I further authorise the use of Ambulance and/or anaesthetic by a qualified medical practitioner if in his/her judgement it is necessary. I accept responsibility for payment of all expenses associated with such treatment.

  • I understand that every effort will be made by the leader firstly to contact the above guardians in the event of any illness or accident.
  • My child agrees to abide by the guidelines of the Priority One programme, and to participate in all aspects of the program.